National Provider Identifier [NPI]: |
1124013404 |
Last Name Of The Provider |
WONG |
First Name Of The Provider |
WALTER |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2424 S 90TH ST |
Street Address 2 Of The Provider |
SUITE 202 |
City Of The Provider |
WEST ALLIS |
Zip Code Of The Provider |
532272455 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
1465 |
Number Of Medicare Beneficiaries |
348 |
Total Submitted Charge Amount |
287942.67 |
Total Medicare Allowed Amount |
159508.11 |
Total Medicare Payment Amount |
120058.98 |
Total Medicare Standardized Payment Amount |
126667.55 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
84 |
Number Of Beneficiaries Age 65 to 74 |
93 |
Number Of Beneficiaries Age 75 to 84 |
92 |
Number Of Beneficiaries Age Greater 84 |
79 |
Number Of Female Beneficiaries |
214 |
Number Of Male Beneficiaries |
134 |
Number Of Non Hispanic White Beneficiaries |
297 |
Number Of Black or African American Beneficiaries |
24 |
Number Of AsianPacific Islander Beneficiaries |
11 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
243 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
105 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
30 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
55 |
Percent Of With Schizophrenia Other PsychoticDisorders |
22 |
Percent Of With Stroke |
24 |
Average HCC Risk Score Of Beneficiaries |
1.721 |